'I went for rehab many times and it never worked, but the harm reduction process has given me renewed hope'. Perceptions on the effectiveness of harm reduction and community-based opioid substitution therapy.

Issue Addressed: The accessibility of opioid substitution therapy (OST), one of the recommended treatments for opioid dependence, remains low. This study sought to explore the perceived effectiveness of OST from the perspectives of peer outreach workers and OST clients in a community-based harm reduction programme.

Methods: The research was done within the Community-Oriented Substance Use Programme (COSUP) in Tshwane, South Africa.

Treatment barriers among young adults living with a substance use disorder in Tshwane, South Africa.

Background: Despite increasing substance use globally, substance use treatment utilisation remains low. This study sought to explore and measure substance use treatment barriers among young adults in South Africa.

Methods: The study was done in collaboration with the Community-Oriented Substance Use Programme run in Tshwane, South Africa.

Coping strategies and mental health of adolescents impacted by parental HIV and AIDS in rural South Africa.

The study explored whether orphanhood status as well as coping strategies predicted mental health outcomes in orphans and vulnerable adolescents who participated in an NGO-supported programme in rural South Africa. Participants comprised 175 adolescents (aged 11-18 years) from a low-resource community, and included non-orphans ( = 57), orphans due to AIDS ( = 62) and orphans due to other causes ( = 56). All participants rated themselves on the age-appropriate Youth Self-Report scales and 95 completed the Children's Coping Strategies Checklist (CCSC).

Khuluma: Using Participatory, Peer-Led and Digital Methods to Deliver Psychosocial Support to Young People Living With HIV in South Africa.

Khuluma is a psychosocial and peer-to-peer mHealth intervention that uses text messaging to facilitate support groups for adolescents living with HIV (ALWH) with the aim of contributing toward positive health outcomes. Although use of mobile technology in the form of mHealth interventions has proliferated recently in the field of health, published literature describing methods and processes of its application are limited. We present a set of methods and processes utilised to develop and pilot the Khuluma mHealth intervention amongst young people (15-20 years) in South Africa.

University students' mental health and emotional wellbeing during the COVID-19 pandemic and ensuing lockdown.

The COVID-19 pandemic and ensuing lockdown had a profound effect on human life. This research explores the influence of COVID-19-related experiences on the emotional wellbeing and mental health of South African university students 3 months into the pandemic. Research data were obtained from an online survey completed by 5074 students.

Pathways to sexual health communication between adolescent girls and their female caregivers participating in a structured HIV prevention intervention in South Africa.

Rationale: Interventions that promote sexual health communication between adolescents and their parents or other primary caregivers are an important tool for reducing female adolescents' behavioral risk. Understanding the mechanisms by which interventions effectively foster communication can inform future programs.

Objective: An initial evaluation of Let's Talk, a structured, family-centered HIV prevention intervention for vulnerable adolescents in South Africa, found an increase in caregiver-adolescent sexual communication.

An mHealth HIV prevention programme for youth: lessons learned from the iloveLife.mobi programme in South Africa.

A mobile-based behavioural change program iloveLive.mobi was implemented to prevent HIV among young people (12-24 years) in South Africa. The mobile site offered access to sexual and reproductive health and psychosocial information through interactive learning.

Maternal HIV status disclosure to young uninfected children: psychological variables of the mother.

Mothers living with HIV are faced with the dilemma of when and how to disclose their HIV-positive status to their young uninfected children. In this study, a South African sample of mothers living with HIV, with young uninfected children (6-10 years) in the city of Tshwane was studied. In the sample of 406 mothers, 11.

Constructions of sexuality and HIV risk among young people in Venda, South Africa: implications for HIV prevention.

The study explored constructions of sexuality among young people of Venda in Limpopo, South Africa, and cultural practices that can be used to develop context-specific HIV prevention programmes. HIV prevention can be promoted by including some cultural practices in prevention programmes and changing some aspects of culture that may contribute negatively to health. Six focus group discussions were held with school-going young people (Grades 10 to 12) in urban and rural areas to explore their constructions of sexuality and HIV risk.

Can family-centered programing mitigate HIV risk factors among orphaned and vulnerable adolescents? Results from a pilot study in South Africa.

Let's Talk is a structured, family-centered adolescent HIV prevention program developed for use in South Africa using key components adapted from programs successfully implemented in the US and South Africa. It is designed to address individual HIV transmission risk factors common among orphaned and vulnerable adolescents, including elevated risk for poor psychological health and sexual risk behavior. These efforts are accentuated through parallel programing to support caregivers' mental health and parenting skills.

Development and formative evaluation of a family-centred adolescent HIV prevention programme in South Africa.

Preventing HIV among young people is critical to achieving and sustaining global epidemic control. Evidence from Western settings suggests that family-centred prevention interventions may be associated with greater reductions in risk behaviour than standard adolescent-only models. Despite this, family-centred models for adolescent HIV prevention are nearly non-existent in South Africa - home to more people living with HIV than any other country.

Laughter therapy as an intervention to promote psychological well-being of volunteer community care workers working with HIV-affected families.

The study explores the experiences of volunteer community care workers working with HIV-affected families, participating in laughter therapy. Laughter therapy is being used as an intervention to positively influence individuals experiencing various forms of emotional distress. Community care workers play a vital role in the support of the HIV/AIDS-infected and -affected members in communities.

Rethinking HIV-prevention for school-going young people based on current behaviour patterns.

The aim of the research was to gain increased knowledge regarding the sexual risk behaviour of school-going young people in South Africa after two decades of HIV-education in schools, to contribute to the development of improved HIV prevention strategies. In collaboration with the Department of Education, a sample of 5305 learners (between 10 and 18 years in Grades 5-12) from high-risk communities were identified. They completed a survey that assessed self-reported sexual risk behaviour and variables that potentially underlie sexual risk, such as attitudes towards preventive behaviour, perceived social norms and self-efficacy (based on the theory of planned behaviour [TPB]) and social factors like caregiver relationships and gender norms (based on the social ecological theory).

Parental HIV/AIDS and psychological health of younger children in South Africa.

Objective: We examined several indicators of psychological health in a sample of orphans and vulnerable children (OVC) to determine if there were significant differences between those orphaned by AIDS and those orphaned by other causes, and if there were gender differences.

Method: Our sample consisted of 119 young children (ages 6-10 years) who participated in a non-governmental organisation (NGO)-supported social services programme in a low-resource, non-urban community in South Africa. We collected data on three groups: non-orphans (OVC1; n = 45); orphans due to AIDS (OVC2; n = 43); and other orphans (OVC3; n = 31).

An expressive art group intervention for sexually abused adolescent females.

Objective: South Africa has a high prevalence of sexual abuse of children and adolescents. Among the numerous adverse consequences of sexual abuse is the difficulty survivors may experience in developing positive self-esteem and maintaining positive relationships. In a low resource setting, an expressive art group intervention tailored to female adolescents who have been sexually abused was implemented and its value explored.

The emotional wellbeing of lay HIV counselling and testing counsellors.

The HIV testing, treatment and care programme of the South African public healthcare system depends on HIV counselling and testing (HCT) that is primarily delivered by lay counsellors. Lay counsellors are expected to educate clients about HIV/AIDS, advocate behaviour change, convey test results and support those infected and affected to cope with the emotional and social challenges associated with HIV/AIDS. This research focuses on the emotional wellbeing of lay HCT counsellors because this influences the quality of services they provide.

Reproductive desires of men and women living with HIV: implications for family planning counselling.

The reproductive desires of people living with HIV/AIDS (PLHIV) of low socioeconomic standing attending public health facilities in South Africa were studied. HIV-positive men, pregnant and non-pregnant women were recruited from two clinics at a large public hospital in Tshwane, South Africa. Individual interviews were used to explore the reproductive desires of HIV-positive participants.

ISIBINDI, creating circles of care for orphans and vulnerable children in South Africa: post-programme outcomes.

This paper presents the evaluation of post-programme outcomes of the ISIBINDI model, a community-based intervention to promote physical and psychosocial well-being of orphans and vulnerable children (OVC) in South Africa. A mixed methods quasi-experimental design was used to investigate the differences between former ISIBINDI participants (18 years and older) and a control group of similar background. ISIBINDI ex-participants at 12 sites (n=427) and a control group of non-participants (n=177) completed a questionnaire which explored level of education and employment, psychosocial well-being and HIV risk behaviour.

A randomized clinical trial of an intervention to promote resilience in young children of HIV-positive mothers in South Africa.

Objective: The objective of this study is to assess the efficacy of an intervention designed to promote resilience in young children living with their HIV-positive mothers.

Design/methods: HIV-positive women attending clinics in Tshwane, South Africa, and their children, aged 6-10 years, were randomized to the intervention (I) or standard care (S). The intervention consisted of 24 weekly group sessions led by community care workers.

The role of parenting in affecting the behavior and adaptive functioning of young children of HIV-infected mothers in South Africa.

Prior investigations suggest that maternal HIV/AIDS poses significant challenges to young children. This study investigates the relationships between mothers' psychological functioning, parenting, and children's behavioral outcomes and functioning in a population of women living with HIV (N = 361) with a child between the ages of 6 and 10 years in Tshwane, South Africa. Utilizing path analysis, findings revealed that maternal depression is related to increased parenting stress and parent-child dysfunction, maternal coping is related to parenting style, and maternal coping, parenting style and stress, and parent-child dysfunction are associated with children's behavior and functioning, with parenting emerging as an important mediator.

Behavior and psychological functioning of young children of HIV-positive mothers in South Africa.

Adults with HIV are living longer due to earlier diagnosis and increased access to antiretroviral medications. Therefore, fewer young children are being orphaned and instead, are being cared for by parents who know they are HIV positive, although they may be asymptomatic. Presently, it is unclear whether the psychological functioning of these young children is likely to be affected or, alternatively, whether it is only when a mother is ill, that children suffer adverse effects.

The coping strategies used over a two-year period by HIV-positive women who had been diagnosed during pregnancy.

Structured interviews were conducted with 224 HIV-positive women diagnosed during pregnancy, at antenatal clinics in Tshwane, South Africa, in order to investigate the use of coping strategies during the first two years after diagnosis. Interviews were conducted between one and four weeks after diagnosis during pregnancy, with three follow-up interviews conducted post-partum. Coping strategies were assessed with an adapted version of the Brief COPE.

Psychosocial variables associated with coping of HIV-positive women diagnosed during pregnancy.

To identify psychosocial variables related to the use of coping strategies by HIV-positive South African women diagnosed during pregnancy, structured interviews were conducted with 224 HIV-positive women at antenatal clinics over a period of 2 years. Two coping styles, active and avoidant coping, were assessed using an adapted version of the Brief COPE. Psychosocial variables associated with changes in coping over time were identified with mixed linear analysis.

Emotional and behavioural barriers to learning and development in the inclusive education classrooms in South Africa: Developing a training programme for teachers.

Objective: The interaction between teachers, classroom strategies and learners experiencing emotional and behavioural barriers to learning and development in a system of inclusive education results in multiple dynamics on different levels. Many teachers in mainstream education lack training to deal with learners experiencing emotional and behavioural barriers. Resistance towards inclusive education is therefore evident.

Development and piloting of a mother and child intervention to promote resilience in young children of HIV-infected mothers in South Africa.

This paper describes the process of developing a parallel intervention for HIV-positive mothers and their young children (6-10 years) with a view to strengthening the relationship between them. Strong mother-child relationships can contribute to enhanced psychological resilience in children. The intervention was developed through action research, involving a situation analysis based on focus group discussions; intervention planning, piloting the intervention and a formative evaluation of the intervention.